Wainscoat, Mandy A

Wainscoat, Mandy A is an individual health care provider with primary practice located at 27 Sycamore St Ste 100, Prime Healthcare, Glastonbury CT 06033-2223. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Wainscoat, Mandy A can be contacted via phone (860) 659-0581.

Contact Information

Primary practice address
27 Sycamore St Ste 100, Prime Healthcare Glastonbury CT 06033-2223
Phone: (860) 659-0581
Fax: (860) 652-3077
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 042898 Connecticut

Profile Details

NPI number 1639156342
LBN Legal business name Wainscoat, Mandy A
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 23rd, 2005
Last updated Mar 20th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639156342 NPPES
Connecticut MEDICAID 001428988
Connecticut Other 040042898CT01
Connecticut Other 042898

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